Provider Demographics
NPI:1609807783
Name:MIGLIORE, SALVATORE A (MD)
Entity Type:Individual
Prefix:
First Name:SALVATORE
Middle Name:A
Last Name:MIGLIORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 VANDERBILT BEACH RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-8708
Mailing Address - Country:US
Mailing Address - Phone:239-624-8220
Mailing Address - Fax:
Practice Address - Street 1:801 VANDERBILT BEACH RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-8708
Practice Address - Country:US
Practice Address - Phone:239-624-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80094207P00000X
IN01068667A207P00000X
FLME80403207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIN628ZOtherMEDICARE
FL017015300Medicaid
FL06038OtherBCBS
INM400058005Medicare PIN
FL06038OtherBCBS
FLIN628ZMedicare PIN
FLIN628ZOtherMEDICARE
FLIN628ZMedicare PIN